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Breastfeeding - "People Don't See The Sacrifice"

Updated: Aug 30, 2023


Content:

  1. August is National Breastfeeding Month

  2. What are the benefits of breastfeeding?

  3. Barriers to breast/chestfeeding

  4. Recommendations and Solutions

  5. Breast/chestfeeding Barriers for Marginalized Families

  6. What can you do to help?


In Beyonce Knowles’ epic documentary “Homecoming”, she recalls the intense training mere months after giving birth to her twins. “My mind was not there. My mind wanted to be with my children. People don’t see the sacrifice, I would dance and go off to the trailer and breastfeed the babies.” [4] Many mothers can empathize with the struggle of balancing career and motherhood, touching on the topic of breastfeeding. Beyonce’s statement is perfect to open the discussion on broader issues that many mothers face in their breastfeeding journeys, including lack of representation for mothers who have been marginalized. Ranging from lack of social support and representation, to economic constraints, the United States does not make the breastfeeding journey easy, for anyone who chooses to breastfeed.


August is National Breastfeeding Month

As August comes to a close, it is important to review why August has been proclaimed by

The United States Breastfeeding Committee as the vital month to portray the importance of

breast/chestfeeding as a prevention and protection strategy for mothers and infants, as well as

the solution for a lifetime of health. [5]


What are the Benefits of breast/chestfeeding?

For many new parents, the postpartum period is characterized with intensive planning

and countless decisions. The choice to breast/chestfeed or formula feed is one of them. Breast

milk is more widely known for its immune and microbial properties, yet breast milk is primarily

composed of protein, which is vital for infant growth and development. [3] Protein is also a carrier

for other crucial nutrients.The benefits of breast milk are vast, and the recommendation from

the American Academy of Pediatrics is to breast/chestfeed for the first 6 months of the infant's

life, followed by the introduction of food alongside breast milk for 1 year. [2] Studies have shown

that the longer an infant is breast/chestfed, the benefits become greater. [1]



Benefits of Breastfeeding for the Infant: [7]

  • Reduced rates of gastric issues in infants

  • Higher cognitive function

  • Higher performance on intelligence tests

  • Reduced risk of long-term obesity

  • Reduced risk of type two diabetes

  • Reduction in long-term higher systolic blood pressure.

  • Decreased risk of sudden infant death syndrome (SIDS)


Benefits of breastfeeding for the mother: [7]

  • Reduced rates of ovarian cancer

  • Reduced rates of premenopausal breast cancer

  • Reduction of obesity risk

  • Reduction of type 2 diabetes incidence

  • Reduced rates of heart disease

  • Aid in post-partum weight loss

Barriers to breast/chestfeeding


With clear benefits of breast/chestfeeding for both the mother and the infant, 83.2% of infants born in the United States were receiving breast milk within their first month of life. However, at six months of age, only 55.8% of infants were fed breast milk along with formula, and only 24.9% of infants were exclusively breast fed. [7] This statistic indicates that although a majority of perinatal mothers choose to breast/chestfeed, many do not follow through with their plans. This is theorized that perinatal mothers face barriers that inhibit their intention to breast/chestfeed. There are many contributing factors, including personal opinions, provider/practitioner influence, and societal and systemic factors.


Provider/practitioner influence could reinforce a negative attitude towards breast/chestfeeding, and also limit hospital-provided lactation support. Societal barriers would include workplace limitations and lack of adequate parental leave policies. The above contributing factors have been studied immensely, thus proving that they inhibit continuation of breast/chestfeeding. As a result, recommendations and solutions are required to ensure proper accessibility for perinatal mothers.



Recommendations and Solutions

Although practitioners are familiar with the benefits of breast/chestfeeding, practitioners should also place focus on including a multidisciplinary team within their practices. The multidisciplinary team should include designated lactation support, which normally includes a registered nurse, doula, counselor, and peer support. The benefits of lactation support are great, due to the prioritization of education and counseling that occurs alongside the mothers’ medical care. Lactation counseling specifically includes discussion of any struggles the mother would be facing, with possible solutions. The overall lactation support would be stable for perinatal mothers.


Practitioners should ensure designated lactation support with every postpartum visit as a centralized point of care being mindful of the coverage available from insurers. Practitioners are highly encouraged to promote lactation support to be covered universally by private insurance companies as well. Currently, in CT, Medicaid (HUSKY) has declared a maternal health bundle covering lactation support with Medicaid (HUSKY) funds. Nationally, breast/chestfeeding support has not been implemented, despite allocated funds through the Affordable Care Act. [10]


Approximately 27.6 million working mothers are left without basic workplace protections regarding breast/chestfeeding. Societal barriers to breast/chestfeeding including workplace limitations and parental leave policies can be reviewed by organizational governing bodies, with lactation support in mind. Postpartum mothers who return to work experience increased difficulty in continuing with their breast/chestfeeding plans, due to workplaces with limited flexibility and inadequate facilities. Workplaces should be encouraged to allow postpartum mothers adequate paid time and privacy to breast/chestfeed. There should be a clean, private location for mothers to express breastmilk, as well as private space for storage of breastmilk. Workplaces should have policies regarding breast/chestfeeding readily available and provided to mothers at any point during pregnancy or postpartum.


In Connecticut, current breast/chestfeeding workplace protections encourage employers to provide a proper space for working mothers to express breastmilk, privately. As of 2021, the requirements for lactation spaces have improved. Lactation spaces now have an outlet and a refrigerator to store expressed milk. This is a step in the right direction for Connecticut. [11]


Breast/chestfeeding Barriers for Marginalized Families

Families that come from communities that have been marginalized face increased barriers when deciding their breast/chestfeeding plans. For example, nationally, Black families continue to have the lowest rates of breast/chestfeeding initiation and continuation, followed by Indigenous and Hispanic families. All of which are significantly lower than breast/chestfeeding rates for white families nationally. Healthcare and lactation support in under-resourced areas is coupled with high rates of preterm birth and complications.


Families that have been marginalized are statistically more likely to live in under-resourced areas where breast/chestfeeding support may not be available. [8] Workplace discrimination and racism is also statistically proven to be a barrier when breast/chestfeeding mothers discuss their return to work plans with their employer. In fact, lactation discrimination was shown to affect low-wage workers of color in overwhelming concentrations. [8] Currently, over one million Black and Brown women are still unprotected by lack of lactation laws. [8] With these current statistics, it is imperative to note that perinatal mothers from marginalized communities continue to face increased hardships and need hyper focused societal support. Hospitals in marginalized communities should initiate and provide lactation support groups tailored to their patient population and their cultural values, language differences, and religious differences.


What can you do to help?

  1. Support lactation laws in your town.

  2. Support movements for your workplace to be breast/chestfeeding friendly.

  3. Support any friends or family members through their breast/chestfeeding journey.

  4. Spread the word on the benefits of breast/chestfeeding.

  5. Conduct your own research on new acts and publications on breast/chestfeeding and see

  6. how you can support your local community.

  7. Consider becoming a Doula

  8. Amplify the stories of Black and Brown mothers.


Sources

  1. Binns C, Lee M, Low WY. The long-term public health benefits of breastfeeding. Asia Pacific Journal of Public Health. 2016;28(1):7-14. doi:10.1177/1010539515624964

  2. Breastfeeding. Home. Accessed August 12, 2023. https://www.aap.org/en/patient-care/breastfeeding/.

  3. Fein SB, Mandal B, Roe BE. Success of strategies for combining employment and breastfeeding. Pediatrics. 2008;122(Supplement_2). doi:10.1542/peds.2008-1315g

  4. Homecoming: A Film By Beyonce. Netflix; 2019.

  5. Mosca F, Giannì ML. Human milk: Composition and health benefits. La Pediatria Medicae Chirurgica. 2017;39(2). doi:10.4081/pmc.2017.155

  6. U.S. Breastfeeding Committee. Accessed August 12, 2023. https://www.usbreastfeeding.org/nbm-proclamation.html.

  7. Pediatrics Department at Cohen Children’s Medical Center. Breastfeeding: Uncovering barriers and offering solutions : Current opinion in pediatrics. LWW. Accessed August 14, 2023. https://journals.lww.com/co-pediatrics/Abstract/2018/08000/Breastfeeding___uncovering_barriers_and_offering.23.aspx.

  8. Exposed: Discrimination against breastfeeding workers. Accessed August 14, 2023. https://repository.uclawsf.edu/cgi/viewcontent.cgi?article=1000&context=wll.

  9. Breastfeeding report card. Centers for Disease Control and Prevention. August 31, 2022. Accessed August 10, 2023. https://www.cdc.gov/breastfeeding/data/reportcard.htm.

  10. Co R-JP. CT Medicaid to cover doulas, breastfeeding. MyRecordJournal.com. Accesse August 24, 2023. https://www.myrecordjournal.com/News/State/doula_medicaid.html.

  11. New Connecticut law expands lactation accommodation requirements. JD Supra. Accessed August 11, 2023. https://www.jdsupra.com/legalnews/new-connecticut-law-expands-lactation-6331249/.


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